由于阿齐尔沙坦的Spru-Like肠病的第一次描述:一个案例报告
Luisa Stoeckli1, Markus Koster1,2, Tugce Tuerkmen-Uthayanan1
1Department of General Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Case reports in gastroenterology
|June 9, 2025
概括
沙坦诱导的肠道病变是一种罕见的血管激素II受体对抗剂 (ARB) 的副作用,现在与阿齐尔沙坦有关. 这一案例突出了阿齐尔沙坦可能引起的慢性腹和体重减轻,需要在接受ARB治疗的患者中考虑.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 沙坦诱导的肠道病变是一种不常见的不良药物反应,与血管激素II受体对抗剂 (ARB) 相关.
- 奥尔梅沙坦是最常见的ARB,与沙坦诱导的肠道病变有关.
- 之前没有报道过阿齐尔沙坦和肠道病变之间的关联.
研究的目的:
- 报告与阿齐尔沙坦相关的沙坦诱导肠道病变的第一个病例.
- 描述临床表现,诊断发现和结果.
- 强调阿齐尔沙坦作为一种可能导致状肠病的潜在原因.
主要方法:
- 一个74岁的男性患者的病例报告,患有过度的非血性腹和体重减轻.
- 组织病理学检查显示了内皮质淋巴细胞病变和肠性缩.
- 诊断工作,包括乳性疾病特异性抗体和对无质饮食的反应.
- 药物去挑战和重新挑战以确认因果关系.
主要成果:
- 该患者出现了模仿乳病的症状,但血清学测试呈阴性,无质饮食无效.
- 停用阿齐尔沙坦导致症状迅速消失,组织学变化消失.
- 药物重新挑战重现了肠道病变,证实了阿齐尔沙坦是致病剂.
结论:
- 阿齐尔沙坦可以引起类似的肠病变,这是ARB治疗的潜在副作用.
- 这种诊断应该考虑在ARB治疗的患者呈现慢性腹和体重减轻.
- 组织病理学发现和药物挑战/再挑战对诊断至关重要.
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